Professional Documents
Culture Documents
It will always be our endeavour to constantly better your experience by innovating and evolving our basket of conveniences. We strive to
deliver service which is personalized and is totally transparent. It is our aim to be with you in your time of need.
The policy has been issued on the basis of the information provided by you. The extract of the information has been enclosed for
your reference. We would request you to peruse the policy and satisfy yourself that it meets with your requirement fully.
Please note : Transfer of benefits under this insurance policy is not automatic on the sale of the vehicle. The transferee must apply
within 14 days from the date of transfer of vehicle in writing to the insurance company with full details in a duly signed fresh proposal
form alongwith evidence of sale and transfer fees of ₹. 50/- + Goods and Service Tax.
Once again, thank you for choosing to insure your vehicle with Future Generali and we look forward to being of service to you.
Assuring you of our best services at all times.
Future Generali India Insurance Company Limited, Registered and Corporate Office address: 801 and 802, 8thFloor, Tower C, Embassy 24X7 Park,
L.B.S. Marg, Vikhroli - West, Mumbai, Maharashtra - 400083 Care Line:- 1800-220-233,1860-500-3333,022-67837800, Email: fgcare@futuregenerali.in,
Website: www.futuregenerali.in. IRDA Regn.No. 132, CIN - U66030MH2006PLC165287
Tax Invoice
INSURED DETAILS
Policy Number : V7992718 Address of Service Provider : Off Code-17,Future Generali India Insurance Co
Ltd, 3rd Flr, Milestone, 12 Wardha Road, Near,
Panchsheel Square, Ramdaspeth, Nagpur,
Invoice Number : 202027PNT0421970
Maharashtra, Pincode - 440010
Received with thanks from a sum of ₹ 7,233.00 towards Premium on the above mentioned policy.
NOTE :
1. In case of payment by cheque, in the event of dishonour of cheque for any reason whatsoever,insurance cover provided under this receipt automatically stands
cancelled from the inception irrespective of whether a seperate communication is sent or not.
2. Excess amount, if any, will be adjusted against subsequent policies, or will be refunded on demand.
(Authorised Signatory)
Future Generali India Insurance Company Limited, Registered and Corporate Office address: 801 and 802, 8thFloor, Tower C, Embassy 24X7 Park,
L.B.S. Marg, Vikhroli - West, Mumbai, Maharashtra - 400083 Care Line:- 1800-220-233,1860-500-3333,022-67837800, Email: fgcare@futuregenerali.in,
Website: www.futuregenerali.in. IRDA Regn.No. 132, CIN - U66030MH2006PLC165287
Future Secure Motor Insurance
CERTIFICATE OF INSURANCE CUM POLICY SCHEDULE - Form 51 of the Central Motors Vehicles Rules, 1989
Policy Servicing : Off Code-17,Future Generali India Insurance Co Ltd, 3rd Flr, Milestone, 12 Wardha Road, Near, Panchsheel
Office Square, Ramdaspeth, Nagpur, Maharashtra, Pincode- 440010., Tel_No: -
Policy No. : V7992718 Period of Insurance : From 00:01 hrs of 23/01/2021 To
Insured : Mr. SAJEDA MAHEBOOB Midnight of 22/01/2022.
DIWAN
Address : P NO 394 BHAURAO NAGAR, Covernote No : - Dated: Zone: B
VMV COLLEGE WARDHAMAN, Intermediary Name/Code : Direct
NAGAR, NAGPUR, Telephone : 1800-220-233,1860-500-3333
MAHARASHTRA, 440008 Previous Policy No : V6899526-02
GSTIN Number : - FGI GSTIN Number : 27AABCF0191R2Z8
INSURED MOTOR VEHICLE DETAILS AND PREMIUM COMPUTATION
Registration No., Make/Model of Vehicle Engine No. Chassis No.
RTA Location
MH49AE5565 MARUTI WAGON R VXI K10BN4848065 MA3EWDE1S00B62308
NAGPUR(E)
Year of Manufacture Cubic Capacity Type of Body Seating Premium
Capacity
2016 998 Saloon 5 7,233.00
DRIVERS CLAUSE :- Any person including the insured: Provided that a person driving holds an effective driving license at the
time of the accident and is not disqualified from holding or obtaining such a license; Provided also that the person holding an
effective Learner’s License may also drive the vehicle and that such a person satisfies the requirements of Rule 3 of the Central
Motor Vehicles Rules, 1989.
LIMITATIONS AS TO USE - As per Motor Vehicle Rules, 1989 :- The Policy covers use of the vehicle for any purpose other
than: a) Hire or Reward, b)Carriage of goods (other than samples or personal luggage), c) Organized racing, d) Pace making, e)
Speed testing, f) Reliability Trials, g) Any purpose in connection with Motor Trade.
Geographical Area : INDIA
IMPORTANT NOTICE
The Insured is not indemnified if the vehicle is used or driven otherwise than in accordance with this schedule. Any payment
made by the Company by reason of wider terms appearing in the certificate in order to comply with the Motor Vehicle Act, 1988
is recoverable from the Insured. See the clause headed “AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY”.
For legal interpretation English version will be good.
For full details on coverage, terms, conditions and exclusions, please refer the standard policy wordings attached with this
schedule.
IMPORTANT - 1) All other Terms, Conditions and Exclusions as per attached Policy Wordings. 2) In case of payment by
cheque, in the event of dishonor of cheque for any reason whatsoever, insurance cover provided under this document
automatically stands cancelled from the inception irrespective of whether a seperate communication is sent or not.
Warranted that the *Vehicle insured herewith has a valid Pollution Under Control (PUC) Certificate as on the inception date
of the policy.(*Not applicable for Electric Vehicles and New Non- Electric Vehicles).
LIMITS OF LIABILITY
Under Section II-I (i) : Death of or bodily injury - Such amount Under Section II-I (ii) : Damage to Third Party Property- ₹
as is necessary to meet the requirements of Motor Vehicles Act, 750000 /- in respect of any one claim or series of claims arising
1988 out of one event.
Under Section III : PA Owner – Driver as per premium Compulsory DeductibleUnder Sec I - ₹ 1,000.00
computation table
Hypothecation Agreement with:- SBI BANK ,
SPECIAL CONDITIONS – NIL
ADDITIONAL EXCESS – NIL
The nominee for Compulsory PA to owner driver cover is 01) LEGAL HEIR, aged :36 Years, Relationship : Legal Executor,
Nomination % : 100%
Future Generali India Insurance Company Limited, Registered and Corporate Office address: 801 and 802, 8thFloor, Tower C, Embassy 24X7 Park,
L.B.S. Marg, Vikhroli - West, Mumbai, Maharashtra - 400083 Care Line:- 1800-220-233,1860-500-3333,022-67837800, Email: fgcare@futuregenerali.in,
Website: www.futuregenerali.in. IRDA Regn.No. 132, CIN - U66030MH2006PLC165287
Policy No : V7992718 Period Of Insurance : From 00:01 hrs of 23/01/2021 To Midnight of 22/01/2022
INSURED'S DECLARED VALUE
For Vehicle -₹ For Non Elec For Side Car-₹ For Elec Accessories- For Bi-Fuel Kit Total Value-₹
Accessories - ₹ ₹ (CNG/LPG) - ₹
291,600 - - - - 291,600
SCHEDULE OF PREMIUM
PARTICULARS ₹ ₹
A-OWN DAMAGE
Basic Premium on Vehicle 2,658.52
Less : No Claim Discount 45% 1,196.33
Add : Add-on Premium 2,041.20
Total Own Damage Premium (A) (rounded off) 3,503.00
B-LIABILITY
Basic Premium including Premium for TPPD 2,072.00
Add : Compulsory PA to Owner-Driver Rs. 15 lacs 330.00
Add : PA to persons other than Owner/Driver (No. of persons 5) PA Limit Rs. 50000 per person. 125.00
Add : PA to Drivers/Cleaner/Conductors (No. of persons 1) PA Limit Rs. 100000 per person. 50.00
Add : Legal Liability to Paid Driver/Cleaner/Employees (No. of persons 1) 50.00
Total Liability Premium (B) 2,627.00
Total Annual Premium (A+B) 6,130.00
Total Premium for the Policy Period 6,130.00
Goods and Service Tax 1,103.40
Total Premium (rounded off) 7,233.00
Class of Vehicle: Private Car Subject to Endorsement Nos. 07 ,22 ,16 ,17 ,28 ,15 ,
I/We hereby certify that the Policy to which this Certificate relates as well as this Certificate of Insurance are issued in
accordance with the provisions of chapter X and chapter XI of M .V. Act, 1988.
For FUTURE GENERALI INDIA INSURANCE CO. LTD.
Receipt No : Y2116228
Date of Issue : 07/01/2021
Place of Issuance : Mumbai*
Note:This document is digitally signed by Sharada Ramakrishnan, Authorised Signatory of Future Generali
India Insurance Company Limited on 07/01/2021
For registration of your Motor Claims SMS MOTORCLAIM to 9222211100 (Standard SMS charges applicable)
The stamp duty of Rs. 0.25/- paid by Letter Of Authorisation No. CSD/150/2020/2413, Dated 29/10/2020. Mudrank - 2017/C.R.97/M-1,dated
09/01/2018.
Future Generali India Insurance Company Limited, Registered and Corporate Office address: 801 and 802, 8thFloor, Tower C, Embassy 24X7 Park,
L.B.S. Marg, Vikhroli - West, Mumbai, Maharashtra - 400083 Care Line:- 1800-220-233,1860-500-3333,022-67837800, Email: fgcare@futuregenerali.in,
Website: www.futuregenerali.in. IRDA Regn.No. 132, CIN - U66030MH2006PLC165287
Annexure
Forming part of policy number:- V7992718
Motor Add-on Cover
Serial Add-on Description UIN No. Premium
No. Amount -₹.
1 Road Side Assistance IRDAN132P0001V03201213 250.00
2 Zero Depreciation Cap IRDAN132P0001V02200910 1,253.84
3 Theft Or Loss Of Keys 268.68
4 Loss Of Personal Belongings - Maximum payable amount 268.68
Laptop:Rs. 50,000 ;Maximum payable amount Mobile: Rs. 25,000
Please refer the attached detailed policy wordings for the above mentioned coverages.
Future Generali India Insurance Company Limited, Registered and Corporate Office address: 801 and 802, 8thFloor, Tower C, Embassy 24X7 Park,
L.B.S. Marg, Vikhroli - West, Mumbai, Maharashtra - 400083 Care Line:- 1800-220-233,1860-500-3333,022-67837800, Email: fgcare@futuregenerali.in,
Website: www.futuregenerali.in. IRDA Regn.No. 132, CIN - U66030MH2006PLC165287
Dear SAJEDA MAHEBOOB DIWAN,
We wish to inform you that the Insurance policy number V7992718 has been issued on the basis of the information and
declaration given by you, the transcript whereof is mentioned below. In case of any disagreement or objection or any changes
with respect to information mentioned below, we request you to please revert back within a period of 15 days from date of your
receipt of this transcript or the policy start date whichever is earlier, failing which it will be deemed that you are satisfied with
the correctness of the details mentioned below. Please be informed that this Policy shall be construed to be void ab initio/invalid
in the event we find that you have not disclosed material or correct information required for the purpose of providing the below
insurance cover and in case of any claim arising under the policy in such a scenario, we shall be under no obligation whatsoever
to settle such claim to you and the premium paid by you under this policy shall stand fully forfeited.
Future Secure Motor Insurance - TRANSCRIPT/DECLARATION
Sr No Insured Details
1 Insured Name SAJEDA MAHEBOOB DIWAN
2 Registration address of the Insured P NO 394 BHAURAO NAGAR, VMV COLLEGE
WARDHAMAN, NAGAR, NAGPUR, MAHARASHTRA,
440008
3 Communication address of the Insured P NO 394 BHAURAO NAGAR, VMV COLLEGE
WARDHAMAN, NAGAR, NAGPUR, MAHARASHTRA,
Pincode :- 440008
4 Residence Telephone no 8956114297
5 Mobile no 9049084263
6 Email id SUNILSAHANE786@GMAIL.COM
Policy Details
7 Policy Number V7992718
8 Risk start time and date 23/01/2021/00:01
9 Risk end date 22/01/2022
10 Renewal NCB % 45%
Vehicle Details
11 Make and Model of vehicle insured MARUTI WAGON R VXI
12 Registration No MH49AE5565
13 Engine No K10BN4848065
14 Chassis No MA3EWDE1S00B62308
15 Cubic Capacity 998
16 Year of Manufacturing 2016
17 RTO where vehicle is/will be registered NAGPUR(E)
18 Seating Capacity 5
19 Date of Registration / Purchase 25/06/2017
20 Usage of the vehicle PV
21 Fuel Type Petrol
22 Hypothecation/Lease/Hire Purchase Hypothecation
23 Bank Name SBI BANK
24 Vehicle * being insured has valid Pollution Under Yes
Control (PUC) Certificate as on inception date of
policy.(*Not applicable for New Vehicle)
Previous Insurance Details
25 Previous Insurer Name Future Generali India Insurance Co. Ltd.
26 Expiring Policy No V6899526
Future Generali India Insurance Company Limited, Registered and Corporate Office address: 801 and 802, 8thFloor, Tower C, Embassy 24X7 Park,
L.B.S. Marg, Vikhroli - West, Mumbai, Maharashtra - 400083 Care Line:- 1800-220-233,1860-500-3333,022-67837800, Email: fgcare@futuregenerali.in,
Website: www.futuregenerali.in. IRDA Regn.No. 132, CIN - U66030MH2006PLC165287
Third Party Coverages Opted
35 Basic Premium including Premium for TPPD Opted
36 Add:-Trailers Not Opted
37 Less : Limit of Liability under sec II-1(ii)-₹. 6000 Not Opted
38 Add : Bi-Fuel Kit (CNG/LPG) Not Opted
39 Add : Geographical Area Extn Not Opted
40 Add : Compulsory PA to Owner-Driver ₹. 15 lacs Opted
41 Add : PA to persons other than Owner/Driver (No. of Opted
persons 5)PA Limit ₹.50000 per person.
42 Add : PA to Drivers/Cleaner/Conductors (No. of Opted
persons 1) PA Limit ₹ 100000 per person.
43 PA to Named Persons other than Owner Driver As per Not Opted
Annexure attached
44 Add : Legal Liability to Paid Opted
Driver/Cleaner/Employees (No. of persons 1)
45 Add : Legal Liability to (No. of persons 0) Not Opted
46 Add : Increased Limit of Liability under sec II-1(ii)-₹. Not Opted
7.5lacs
Own Damage Coverages Opted
47 Basic Premium on Vehicle Opted
48 Add : Non-Electrical Accessories Not Opted
49 Add : Electrical/Electronic Accessories Not Opted
50 Add : Bi-Fuel Kit (CNG/LPG) Not Opted
51 Add : Trailers Not Opted
52 Add : Geographical Area Extn Not Opted
53 Add : Embassy Loading Not Opted
54 Add : Fibre Glass Tanks Not Opted
55 Add : Driving Tutions Not Opted
56 Add : Rallies Not Opted
57 Less : Anti Theft Not Opted
58 Less : Vehicles Specially Designed/Modified For Not Opted
Handicapped Persons
59 Less : Use confined to own premises Not Opted
60 Less : Automobile Association Membership Not Opted
61 Less : Vintage Car Not Opted
62 Less : Voluntary Deductible-₹. 0 Not Opted
63 Add : Add-on Premium Opted
Nominee Details
64 Nominee Name LEGAL HEIR
65 Nominee Relationship with Insured Legal Executor
66 Nominee Age in Y or M 36Y
67 Nominee % 100
68 Appointee Name -
69 Relationship of Appointee with Nominee -
On examination of the Policy, if you notice any mistake, please return the Policy to the Company immediately for correction.
Any modification(s) in the policy resulting in additional premium, will be applicable from the inception of the policy and this has
to be paid by you immediately to keep the policy coverage intact.
In case of Disagreement or objection or any changes with respect to information and contents mentioned hereinabove, please
contact our Help Line numbers & register your objections/changes/disagreement to the contents of this transcript or you may also
send us email or written correspondence at the below address within a period of 15 days from date of receipt of this transcript or
the policy start date whichever is earlier.
Future Generali India Insurance Company Limited, Registered and Corporate Office address: 801 and 802, 8thFloor, Tower C, Embassy 24X7 Park,
L.B.S. Marg, Vikhroli - West, Mumbai, Maharashtra - 400083 Care Line:- 1800-220-233,1860-500-3333,022-67837800, Email: fgcare@futuregenerali.in,
Website: www.futuregenerali.in. IRDA Regn.No. 132, CIN - U66030MH2006PLC165287
ENDORSEMENTS
(Attached to and forming part of policy)
Future Generali India Insurance Company Limited, Registered and Corporate Office address: 801 and 802, 8thFloor, Tower C, Embassy 24X7 Park,
L.B.S. Marg, Vikhroli - West, Mumbai, Maharashtra - 400083 Care Line:- 1800-220-233,1860-500-3333,022-67837800, Email: fgcare@futuregenerali.in,
Website: www.futuregenerali.in. IRDA Regn.No. 132, CIN - U66030MH2006PLC165287
ENDORSEMENTS
(Attached to and forming part of policy)
Future Generali India Insurance Company Limited, Registered and Corporate Office address: 801 and 802, 8thFloor, Tower C, Embassy 24X7 Park,
L.B.S. Marg, Vikhroli - West, Mumbai, Maharashtra - 400083 Care Line:- 1800-220-233,1860-500-3333,022-67837800, Email: fgcare@futuregenerali.in,
Website: www.futuregenerali.in. IRDA Regn.No. 132, CIN - U66030MH2006PLC165287